Medicaid expansion faces uncertain future in Legislature

Gov. Rick Scott dropped a bombshell Wednesday when he announced support for a Medicaid expansion. But a day later, it remained unclear whether the idea would get through the Republican-dominated Legislature.

House GOP leaders appear to have the strongest reservations, with Speaker Will Weatherford, R-Wesley Chapel, and Appropriations Chairman Seth McKeel, R-Lakeland, publicly expressing doubts about the wisdom of the expansion.

“I remain skeptical that that’s in the best interests of the state," McKeel said Thursday morning.

Weatherford, during an appearance before the Florida Retail Federation and in a television interview, also repeatedly used the word "skeptical." Pointing to broader federal budget and debt problems, he questioned whether Washington would make good on a promise to pay billions of dollars for the expansion.

"We’re talking about a federal government that is not able to pay its bills,’’ Weatherford said during an appearance on the show, "Florida Face to Face."

Some Senate Republicans indicated they might be more willing to go along with Scott, who said he would support expanding Medicaid eligibility for three years and then revisiting the issue. The federal government is slated to pay all of the expansion costs for the first three years, before the state has to pick up a portion of the tab.

"I support the governor, and I think the Senate has an open mind on it,’’ said Sen. Jack Latvala, R-Clearwater. He later added, "I think we give it a shot and see how it works."

Senate Health Policy Chairman Aaron Bean, R-Fernandina Beach, pointed to the possibility that a Medicaid expansion could help "safety net" hospitals that serve large numbers of low-income and uninsured people. More Medicaid coverage would produce additional revenues for hospitals, helping offset other types of funding cuts.

Scott, who anchored his political career on opposing President Obama’s efforts to revamp the health-care system, drew national headlines for his announcement that he would support going ahead with the Medicaid expansion. Hundreds of thousands of Floridians would become newly eligible for the government-run health program, with the federal government paying 100 percent of the costs from 2014 through 2016 and later paying 90 percent.

House and Senate select committees have been studying the Affordable Care Act for weeks and are expected to make recommendations in early March about issues such as the Medicaid expansion. Those recommendations will be initial signs of how Republicans in both chambers view the expansion.

The governor’s stance has drawn criticism from many conservatives, who accuse him of flip-flopping on his opposition to the federal law dubbed Obamacare. But Republican lawmakers are also in a politically tricky position, as going along with the expansion could outrage many of their base voters.

Sen. John Thrasher, a St. Augustine Republican who is a former chairman of the state Republican Party, said he thinks Scott is trying to lead on a "tough, difficult issue."

"There are a number of Republican governors around the country —Gov. (John) Kasich, for one, in Ohio and the governor of Arizona — who have also agreed to do this, so it’s about leadership and that is what the governor is showing on this,’’ Thrasher said. "That doesn’t mean that the Legislature has to agree with everything he says, but I’m proud of his leadership."

U.S. Health and Human Services Secretary Kathleen Sebelius said during a conference call Thursday that she has been encouraged to see states move toward expanding Medicaid, adding that they are "deciding this deal is simply too good to pass up."

But state Agriculture Commissioner Adam Putnam ripped the idea of expanding Medicaid, calling it "not the right direction for the state of Florida." He also directly took aim at Scott’s position that the state could re-evaluate whether to continue the expansion after three years, an idea known as a "sunset" of the expansion.

"In three years, you don’t get a do-over just because it sunsets, which is a classic Tallahassee or a Washington bait and switch,’’ Putnam told members of the Florida Retail Federation. "You don’t get a do-over once you’ve enrolled 1.3 million new people. You don’t get to say, ’Sorry it’s sunsetted, we’re booting you off the rolls.’ You get one chance to make this decision."